Familiarization with Blood

and Blood Components

Abelardo J. Alera, MD,
FPSP, FPSMID, MHSA
Chief
Region VII Blood Center
Cebu City
Blood and Blood Components
considered drugs because of their use
in treating diseases
Treat two conditions;
•inadequate oxygen carrying capacity
(anemia/ blood loss)
•inadequate hemostasis
(insufficient coagulation proteins/
platelets)
Each patients require individualized
plan reflecting the patient’s
•changing clinical condition
•anticipated blood loss
•capacity for compensatory mechanisms
•laboratory results
Component therapy
•transfusion of the specific blood
component needed by the patient
•several patients can be treated with
the blood from one donor, giving
optimal use of every donation of
blood
Learning Objectives
•Describe the blood components
available for therapeutic use
•Differentiate the blood components
•Discuss the composition of each
blood component
•Discuss Blood Safety
Rationale for component therapy
•Whole blood transfusion rarely
necessary
•Patient will be better served if given
only the specific blood component
needed
•Need to conserve limited blood
resources
Reasons for shortage blood supply
•Difficulty in getting a blood donor
•Cost incurred
•Inappropriate use of
blood its components
Some patients do not require
transfusion even in anemia
or thrombocytopenia
because their clinical
conditions are stable,
they have little/ no risk of
adverse outcomes
(iron-deficiency anemia with minor
symptoms)
 Common blood products
available for transfusion
•Components that contain RBCs
•Components that do not contain RBCs
•Commercially prepared blood
derivatives
I. Components that contain
RBCs
• Whole blood
• Packed red blood cells
• Washed red blood cells
• Leukocyte-reduced red blood cells
• Deglycerolized red blood cells
II. Components that do not contain
RBCs
•Fresh frozen plasma
•Cryoprecipitate
•Platelet concentrate
•Platelet, pheresis
•Granulocyte, pheresis
III. Commercially prepared blood
derivatives
•Factor VIII concentrate
•Factor IX concentrate
•Albumin solutions
•Plasma protein factors
•Immune serum globulin
•Rh immune globulin
Fresh whole blood
Current practice has no scientific
justification for its use
EXCEPT:
– Exchange transfusion in NB
– Massive blood loss
Whole blood
•Indication – actively bleeding with
loss of 30% of the blood volume
•Characteristics
– provides both oxygen-carrying
capacity and blood volume
– RBC and plasma
(coagulation factors decrease
after 2 days of storage)
Whole blood
•Approximate volume – 520 ml
(450 ml blood + 63 ml CPDA-1)
•Shelf life – 35 days at 1 to 6 degrees
centigrade
•Effect of transfusion of one unit –
increase hematocrit by 1 to 3 %
Packed red blood cells
•Indication – to increase oxygen-
carrying capacity in symptomatic
anemia patients
•Not to be used
– in place of hematinics
– to improve general “well-being”
Packed red blood cells
•Characteristics – RBC and reduced
plasma (20 ml)
•Approximate volume
– 260 ml (225-350 ml blood + 20 ml
residual plasma)
•Shelf life
– 35 days at 1 to 6 degrees C
•Effect of transfusion of one unit –
increase in hematocrit by 3%
Washed RBC
•Indications
– increase red cell mass
– used to prevent febrile allergic
reactions to leukocyte or plasma
proteins
•Characteristics
– RBCs, no plasma, WBC<5 x 108
– Expiry date: 24 hours
Washed RBC
•Preparation
– automated or manual method
– add NSS to RBCs followed by
mixing, centrifugation, removal
of supernant saline and plasma
solution (repeated until most
WBCs, platelets and plasma
removed)
Leukocyte-reduced RBC
•prepared by filtration of RBCs
before or after storage using
leukocyte-depleting filters
•Indication – prevent febrile
non-hemolytic transfusion reaction
due to sensitization to leukocyte
antigens
Components containing RBC
Blood Component Composition
(Volume in ml)
WB RBC, few WBC and
(500-520) platelets
PRBC RBC, reduced
(250-260) plasma, few WBC
and platelets
Washed RBC RBC, no plasma,
(180-250) WBC <5 x 108
Leukocyte-reduced > 80% of original
RBC RBC, few platelets,
WBC <5 x 108
(200)
II. Components that do not
contain RBC
•FFP
•Cryoprecipitate
•Platelet concentration
•Platelets, pheresis
•Granulocytes, pheresis
FFP
•Indications
– bleeding patients with multiple
coagulation deficiency problems
(DIC, liver diseases)
– useful for Factors V and
XI deficiency
•not to be used as plasma expander
or source of protein nutrition
(risk of TTIs)
FFP
•Characteristics
– plasma proteins, coagulation factor
– prepared by centrifuging a unit of WB
at 4 degrees C. Plasma is separated
from the RBC, placed at -18 degrees C
or lower, within 8 hours from blood
collection
•Approximate volume – 200 to 260 ml
•Shelf-life -one year at -18 degrees C
Cryoprecipitate
•Indications
– von Willebrand disease,
Factor XIII deficiency, hemophilia A,
hypofibrinogenemia
•Characteristics
– 80 units of F VIII, other plasma
proteins, vWF, fibrinogen (150 mg)
Cryoprecipitate
•Prepared by thawing (overnight) a unit
of FFP between 1 to 6 degrees C,
small amount of white precipitate,
removal of supernatant plasma
•Approximate volume – 10 to 15 ml
•Shelf-life – 1 year at -18 degrees C
Platelet concentrate
•Random-donor platelets
•Indications – platelet disorder,
bleeding due to thrombocytopenia
•Component preparation –
separated within 6 hours of
collection of WB that has been kept
at room temperature before the
separation process
Platelet concentrate
•Characteristics
– 5.5 x 1010 , few WBC, RBC, 50 ml of
plasma
– six to ten units raises PC to 50,000/ml
•Approximate volume – 50 ml
•Shelf-life – 5 days room temperature
(20-24 degrees C),
constant gentle agitation
Single donor Platelet concentrate
•Indication – similar to random-donor
platelet
•Component preparation – uses a
machine that removes WB from
a donor, mechanically separates this
into desired blood components,
remaining fraction is returned to the
donor
Components that do not contain RBC
Blood Component Expiration date
(volume in ml)
FFP 24 hours of thawing
(220)
Cryoprecipitate 6 hours of thawing
(10-15)
•Platelet concentrate Up to 5 days
(50)
•Platelets conc, SD 24 hours of preparation
(300)
 Approximate time required for
preparing for a blood transfusion
Procedure Time (minutes)
Collecting the blood 10-15
ABO and Rh typing 10
ABO and Rh typing, 45
antibody screening
Typing, antibody screening, 60
cross-matching
FFP thawing 40
Cryoprecipitate thawing 20
Washing RBCs 45
Blood transfusion
2. Is it safe?
3. Guarantee it will
not cause TTIs?
 Safe Are there any leaks?
Blood Have you squeezed the pack?
Look for blood here.
Transfusion Look for large clots
What to look for.. in the plasma.

Look for hemolysis Look for hemolysis

at the line between in the plasma. Is the
The red cells and plasma plasma pink?

Look at the red cells.

Are they purple or
Clinical Blood Use Handbook
black? WHO 2004
 Who gets the blood?
1 am, only a unit of blood is available

1. 5-year old female child with dengue hemorrhagic fever

2. 79-year old man with prostatic cancer
3. 35-year old woman who underwent C-section
4. 25-year old delivery man from Jollibee who had serious VA
5. 45-year old policeman who was shot by a snatcher
6. 60-year old woman with anemia needing a dialysis
Dili dali mangita ug dugo

Give life…
it’s in your blood!